Individual provider Active NPI

Michael Duane Simmons, MD

  • Emergency Medicine Physician
  • Odessa, TX
National Provider Identifier
1194735258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D7684 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-1189
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D7684 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

2941 Bainbridge Dr
Odessa, TX 79762-5171
Phone (432) 559-2933

Other identifiers 1

IdentifierTypeStateIssuer
D7684OtherTXALLOPATHIC PHYSICIAN LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine Past Accepting new patients
Trans Pecos Emergency Physicians Emergency Medicine Past Accepting new patients
R & R Emergency Service, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194735258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 BAINBRIDGE DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625171",
            "telephone_number": "432-559-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MICHAEL",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "D7684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLOPATHIC PHYSICIAN LIC",
            "identifier": "D7684",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.